[Natural history of ovarian adenocarcinomas: from epidemiology to experimentation]

The ovarian carcinogenesis is not well known because the diagnosis is usually delayed to an advanced stage with a lot of chromosomic abnormalities. On the other hand, there is a lack of animal models and preneoplastic patterns are discussed. Different ways of studying are in progress. Prophylactic oophorectomy in women with BRCA1 mutation provides ovaries that can be compared to a control group. Epithelial or stromal changes are observed in the familial risk group more frequently than in the controls and could be preneoplastic. An experimental approach has been developed in order to confirm the Fathalla's theory of the incessant ovulation by culturing cells of rat surface ovarian epithelium with a high proliferative pressure. These cells become malignant in 10 out of 30 cases (after 10 cultures). The transformed tumor cells are a syngeneic tumor model that can be transplanted in the animal and analysed by molecular biology technics. This allowed to show the loss of a potentially tumor suppressor gene, lot 1, in the transformed cells and on the other hand the overexpression of a gene coding for a protease enzyme the cathepsin B, which is a marker of an aggressive metastatic power.